http://journals.lww.com/greenjournal/pages/collectiondetails.aspx?TopicalCollectionId=96
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http://journals.lww.com/greenjournal/Fulltext/2014/06000/Improving_Care_for_Depression_in_Obstetrics_and.14.aspx
OBJECTIVE: To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care.
METHODS: A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depression, dysthymia, or both (Mini-International Neuropsychiatric Interview). Women were randomized to 12 months of collaborative depression management or usual care; 6-month, 12-month, and 18-month outcomes were compared. The primary outcomes were change from baseline to 12 months in depression symptoms and functional status. Secondary outcomes included at least 50% decrease and remission in depressive symptoms, global improvement, treatment satisfaction, and quality of care.
RESULTS: Participants were, on average, 39 years old, 44% were nonwhite, and 56% had posttraumatic stress disorder. Intervention (n=102) compared with usual care (n=103) patients had greater improvement in depressive symptoms at 12 months (PWed, 21 May 2014 16:00:16 GMT-05:0000006250-201406000-00014http://journals.lww.com/greenjournal/Fulltext/2014/06000/Indomethacin_and_Antibiotics_in.23.aspx
OBJECTIVE: To evaluate whether perioperative indomethacin and antibiotic administration at the time of examination-indicated cerclage placement prolongs gestation.
METHODS: This is a randomized controlled trial performed at a single tertiary care hospital between March 2010 and November 2012. Women older than 18 years of age with a singleton pregnancy between 16 0/7 and 23 6/7 weeks of gestation undergoing an examination-indicated cerclage were eligible. Women were randomly assigned to receive either perioperative indomethacin and antibiotics or no perioperative prophylactic medications. The primary outcome was gestational latency after cerclage placement. Fifty women were required to be randomized to show, with 80% power, a 28-day improvement in latency assuming a latency without intervention of 50±35 days.
RESULTS: Fifty-three patients were enrolled with three lost to follow-up. A greater proportion of pregnancies were prolonged by at least 28 days among women who received indomethacin and perioperative antibiotics (24 [92.3%] compared with 15 [62.5%], P=.01). However, gestational age at delivery and neonatal outcomes were statistically similar between groups.
CONCLUSIONS: Among women receiving an examination-indicated cerclage in the second trimester, gestation was significantly more likely to be prolonged by 28 days among women who received perioperative indomethacin and antibiotics.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov , www.clinicaltrials.gov , NCT01114516.
LEVEL OF EVIDENCE: I]]>Wed, 21 May 2014 16:01:00 GMT-05:0000006250-201406000-00023